Glycemic Load Diet Cookbook: 150 RECIPES TO HELP YOU LOSE WEIGHT AND REVERSE INSULIN RESISTANCE docx

These scientists developed a way of measuring the effects of various foods on blood sugar and insulin levels called the glycemic index.. 1 How the Glycemic-Load Diet Works Before we get

Glycemic Load Diet Cookbook

150 RECIPES TO HELP YOU LOSE WEIGHT AND REVERSE INSULIN RESISTANCE

ROB THOMPSON, M.D & DANA CARPENDER

Glycemic

Load Diet Cookbook

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disastrous, but his pride in my writing was

an endless source of joy

—Dana

To my wife, Kathy, for her support

and encouragement

—Rob

Introduction: Welcome to The Glycemic-Load Diet

Cookbook ix

1 How the Glycemic-Load Diet Works 1

2 Going Low Glycemic Load 21

3 Eggs and Dairy 43

4 Baked Goods and Other Grainy Stuff 65

5 Snacks and Other Pickup Food 87

6 Side Dishes and Side-Dish Salads 99

7 Main-Dish Salads and Soups 135

10 Pork and Lamb 193

11 Fish and Seafood 211

12 Desserts 225 Appendix A: Glycemic Loads of Common Foods 243 Appendix B: Converting to Metrics 251 Index 253

Welcome to The Glycemic-Load

Diet Cookbook

Carb Science: A Note from Dr Rob

In the past, doctors took the old saying “You are what you eat” literally They fi gured you got fat from eating fat and cholesterol buildup in your arteries from eating cholesterol In the 1960s, scientists discovered a link between high blood cholesterol levels and heart disease and made an assumption that changed the way Americans ate for decades They assumed, without proof, that high blood cholesterol came from eating too much cholesterol Soon government agencies began telling people to eat fewer eggs and dairy products and less red meat Low-cholesterol diets were supposed to be not only good for your arteries but also thriftier, kinder to animals, and friendlier to the planet How could you go wrong?

Americans actually did as they were told Average consumption

of eggs, dairy products, and red meat declined steadily for three decades The result? People kept right on having heart attacks Fol-lowing the advice to cut cholesterol had no effect on the incidence

of heart disease Research subsequently showed that fat, cholesterol diets are ineffective for preventing heart disease and don’t even lower blood cholesterol levels much

low-What doctors didn’t know then that they know now is that most of the cholesterol in your blood does not come from food Your liver makes about three times more cholesterol than you eat

If you eat less, it makes more If you eat more, it makes less In

fact, most of the cholesterol you eat passes right through your digestive tract without being absorbed at all It’s not how much cholesterol you eat that determines your blood cholesterol level; it’s how readily your body gets rid of it, and that’s a genetic thing When it comes to cholesterol, who your parents are is much more important than what you eat.

Actually, there’s nothing inherently wrong with reducing your fat and cholesterol intake The problem is, if you eat less of one kind of food, you usually end up eating more of another Sure enough, when Americans started cutting down on eggs, meat, and dairy products, they began eating more carbohydrates, but not the healthful kind—not fresh fruits and vegetables They started

eating more starch—and not just a little more but a lot more By

1997, Americans were eating 48 percent more wheat, 186 cent more rice, and 131 percent more frozen potato products (read french fries) than they had in 1970

per-That’s a big change in eating behavior You would expect it

to have some effect Indeed it did—a bad one The obesity rate skyrocketed in perfect tandem with the increasing carbohydrate consumption By 1997, the percentage of Americans who were overweight had doubled; the diabetes rate, which tracks the obe-sity rate, tripled

The old mantra “You are what you eat” is misleading Your body can quickly turn carbohydrate to fat, fat to carbs, and both

to cholesterol You defi nitely do not need to eat fat to get fat Refi ned carbohydrates like bread, potatoes, and rice actually have more potential to make you fat than fat itself does These foods are full of starch, and as soon as starch reaches your digestive tract, it turns to sugar Starch delivers more sugar into your bloodstream and does it faster than any other kind of food, including sugar itself These blood sugar surges cause your body to produce huge amounts of insulin, a hormone that, in excess, is notorious for promoting weight gain

Starch does another peculiar thing It short-circuits into your bloodstream in the fi rst foot or two of your intestine Unlike most foods, it never traverses the last twenty feet, where several appetite- suppressing hormones come from An hour or two after you eat it, you’re hungry again

Knowing what food scientists know now about carbohydrate

metabolism, it’s not surprising that America’s shift away from fat

and cholesterol toward a diet high in refi ned carbohydrates caused

an epidemic of obesity and diabetes

About the time scientists were discovering a relationship

between high blood cholesterol and heart disease, Dr Robert C

Atkins, an experienced New York cardiologist, noticed that many

of his overweight patients lost weight if they strictly avoided

car-bohydrates even as they continued to eat satisfying amounts of rich

food, including plenty of fat and cholesterol He developed a diet

that restricted all carbohydrates, including sugar, grains, potatoes,

and sugar-containing fruits and vegetables, but allowed dieters to

eat all of the cholesterol- and fat-containing food they wanted—

meat, cheese, butter, eggs, nuts, avocados, olives, and oils His

experience convinced him that low-carbohydrate, liberalized-fat

diets did not cause heart disease or high cholesterol

His timing couldn’t have been worse Government agencies had

begun sounding the alarm about cholesterol, and Atkins’s advice to

eliminate carbs and not worry about cholesterol was anathema to

them As cholesterol fears gripped the American public, his diet fell

from popularity It took thirty years for researchers to fi gure out

that Atkins was right When they fi nally put the low-carbohydrate

diet to the test, they found that subjects who eliminated

carbohy-drates but continued to eat unrestricted amounts of fat and

cho-lesterol lost more weight without even trying to cut calories than

those on low-fat diets who tried to reduce calories There were no

heart problems The balance between good and bad cholesterol—

the best predictor of heart disease risk—actually improved

I have seen many patients who have tried the Atkins diet, and

the results are sometimes astonishing For some it is as if they stop

ingesting a toxin that has been poisoning them for years Fat seems

to virtually melt away even as they eat plenty of rich food Their

cholesterol and blood sugar levels usually look better than ever

You would think that a diet that allows unlimited amounts

of rich food and yielded such gratifying results would be easy to

follow The problem is food cravings Eliminating carbs at fi rst

might seem easy, but soon you start craving the foods that are

missing You long for more fruit, vegetables, starches, and sweets

The result is that most people who try Atkins’s radical low-carb diet give it up The diet fell from popularity, not because of cho-lesterol problems—it was proved safe—and not even because of hunger since you could eat all you wanted Irresistible cravings for the foods that were missing made the diet diffi cult to stick with.These days, scientists know a lot more about carbohydrate metabolism than they did when Atkins fi rst publicized his diet

A breakthrough occurred when researchers at the University of Toronto discovered that when it comes to their effects on blood sugar and insulin levels, not all carbohydrates are the same Some raise blood sugar levels more than others do, despite similar car-bohydrate contents These scientists developed a way of measuring the effects of various foods on blood sugar and insulin levels called

the glycemic index This concept, which was only in its infancy

when the low-carb movement began, evolved into a powerful tool

called the glycemic load.

Being able to know the glycemic load of various foods is great news for people trying to avoid blood sugar surges It narrows

the list of culprits down to two kinds of foods: starch-containing

solids and sugar-containing liquids There is no need to worry

about fruits and vegetables or even some sweets It makes little difference whether the carbohydrate content of one is greater than another Their glycemic loads are minor compared to those of the two main offenders, starches and sugar-containing soft drinks Coupled with what scientists now know about fat and cholesterol, the glycemic-load measurements open the door to a style of eating

that is more rich and fl avorful than the way most people eat when

they aren’t worrying about what they’re eating Indeed, it’s an

eat-ing style—so simple that it’s hard to think of it as a diet—that’s easy enough to follow for life

Recently, the editors at McGraw-Hill and I marveled at how the glycemic load paves the way to an especially rich and fl avorful, yet healthful, cuisine We became excited about the idea of pub-lishing a cookbook based on new concepts about diet and decided

to ask the diva of low-carb cuisine herself, Dana Carpender, if she would apply her considerable talents to the task

Dana is a nationally recognized nutritional expert and book author who has published several bestselling cookbooks,

cook-including 500 Low-Carb Recipes and The Every Calorie Counts

Cookbook For years she had a nationwide syndicated column on

low-carb cuisine For years she published the e-mail newsletter

Lowcarbezine! and has recently begun blogging at holdthetoast

.com I have been impressed with Dana’s extensive knowledge of

food preparation and nutrition as well as her fi ne food sense Dana

understands how new knowledge about nutrition can set food

lov-ers free All you need to do is glance at a few of her recipes to see

how pleasurable reducing your glycemic load can be

Low-Carb Cooking: A Note from Dana

The best part of my job is that people send me free stuff

No, that’s not true The best part of my job is that I get e-mail

from readers, telling me my books have changed their lives for the

better The other best part of my job is that I get to stay home with

my dogs, putter around the kitchen, try new recipes, and make a

living doing it

But the best perk of my job is that people send me free stuff

Food, wine, books Especially books Piles and piles of books!

Mostly cookbooks, which is great, because I collect them But they

send me nutrition books too

That’s how I wound up reading The Glycemic-Load Diet by

Dr Rob Thompson: His publisher sent me an advance copy,

hop-ing I’d review it in print It took me a while to get around to

reading it Then my Internet service went dead for a week, and I

read three books before it came back up One of them was The

Glycemic-Load Diet.

I’ve read a lot of low-carb books, many of them very useful

I’ve known for a long time that different people, with their

dif-fering bodies and lifestyles and goals, fi nd different approaches

to carbohydrate restriction to be the right fi t I’ve never backed

one form of carbohydrate restriction to the exclusion of other

approaches Communication with other low-carbers made it clear

from the beginning of my journey that carbohydrate tolerance

var-ies widely, as do people’s lives and “food demons.” As a result,

different approaches work well for different people

The bottom line in choosing a nutrition plan is “Can you do it

forever?” Because that’s what it takes, not just to keep the weight

off, but to keep your blood sugar and insulin levels down and

to prevent the vast and frightening array of health problems that come from high insulin and blood sugar.

The thing that struck me about Dr Rob’s Glycemic-Load

Diet was how simple and straightforward it is There are just two

simple rules: no starches, no sugary beverages In a fi eld where the waters can easily be muddied by needless complexity, that’s a real strength The diet also struck me as easy to live with since it requires no counting or measuring or keeping track of anything

I also liked that Dr Rob’s main focus is not so much weight loss as overall health, particularly helping the rapidly growing dia-betic and prediabetic population avoid the nasty consequences of out-of-control blood sugar and insulin levels

In short, I thought Dr Rob’s approach would make a lot of sense for a lot of people, and I said so, both in my column and on

my website I was instantly enthusiastic when McGraw-Hill asked

me if I’d be interested in writing the companion cookbook

I don’t have any problem eating a low-carbohydrate diet I don’t struggle with it I’m not plagued by cravings I don’t gaze wistfully

at the pasta selections on menus when I go out to eat I don’t hear doughnuts calling to me I’m a feel-good junkie Eating this way makes me feel great, so it’s what I want to do It’s that simple

I realize this makes me something of a freak Many people would quite literally rather die than change their eating hab-its—indeed, they do it every day I hope you’re not one of them Throughout the recipes on the following pages, I’ll be guiding you through the ins and outs of cooking and eating according to

Dr Rob’s glycemic-load diet, drawing on Dr Rob’s expertise of course The purpose of this cookbook is to help you slash your glycemic load and make this a permanent lifestyle change by giv-ing you many, many answers to the pressing question “What the heck do I eat now?”

When you fi nd the answer to that question, you will discover yourself losing weight and feeling great too You’ll wonder what took you so long

Glycemic Load Diet Cookbook

1

How the Glycemic-Load

Diet Works

Before we get started, it will be helpful for you to know

two defi nitions:

Glycemia: the presence of the sugar glucose in the blood Glycemic: having to do with glucose in the blood

Unless you’ve been living under a rock, you’ve heard the term

glycemic lately A high-glycemic-load diet—a diet that raises blood

sugar levels—is turning out to be correlated with most of the eases we used to blame on fat intake: obesity, heart disease, female infertility, high blood fats, acne, insulin resistance and diabetes, even some cancers

dis-But what does it mean? What is the low-glycemic-load diet?

A low-glycemic-load diet (what I call simply the glycemic-load

diet in this book for the sake of brevity) is an eating style that

greatly lessens the amount of insulin your body has to make It does this by preventing large amounts of glucose from rushing into your bloodstream all at once Eliminating these “glucose shocks” not only helps you lose weight while continuing to enjoy satisfying amounts of good food but also can dramatically improve the way you feel and actually lengthen your life

Before I explain this way of eating, let me give you a little background Chances are you feel guilty about being overweight You’ve been told all your life that it’s just a matter of willpower, that it’s all about “calories in, calories out,” that all you have to

do is eat less and exercise more and you’ll lose weight and improve

your health If you’re overweight, you must lack self-control But

is this true? Study after study has demonstrated that overweight people are no less disciplined than normal-weight people No one can just dial down the number of calories he or she eats at will

We all know what the failure rate is for calorie-restricted diets Chances are you’ve contributed to that statistic yourself

Obesity results not from lack of willpower but from an ance in the body’s hormones, substances that govern body chem-istry The best way to lose weight is to correct the underlying hormonal disturbances that caused you to gain weight in the fi rst place When people do that, they are often amazed at how easy it

imbal-is to lose weight and keep it off What went wrong to make you gain weight? It has to do with the way your body balances the energy you put into it versus the energy it expends

How Your Body Uses Energy

What exactly is a calorie, anyway? A calorie is a measurement of energy Just as we buy gasoline for our cars in gallons (or, outside the United States, in liters), we buy fuel for our bodies in calories There are four sources of calories: protein, carbohydrate, fat, and alcohol You may be surprised to hear that, despite all the low-fat propaganda, the biggest source of calories in the American diet by far is not fat but carbohydrate

The main purpose of body fat is the same as the gas tank on your car: to let you carry a supply of fuel around with you to pro-vide a steady source of energy between refuelings—in this case, between meals

The idea behind fat-restricted diets was the belief that we ally “are what we eat”— that we get fat because we eat too much fat If we cut dietary fat, we’d automatically eat fewer calories, and

liter-as a result we’d burn our own fat—the “fuel in the tank”—instead The only problem is it didn’t work Twenty years of cutting fat

have left Americans fatter, sicker, and more tired, not to mention with a spanking-fresh epidemic of type 2 diabetes Why?

It turns out that there are several problems with the notion that a calorie is a calorie is a calorie: for one, we’re not cars; we’re complex living organisms Unlike a car, which will run at the same rate right up to the moment when it sputters and dies for lack of fuel, your body has powerful mechanisms to balance the energy you take in with the energy you burn up When you eat fewer calories, your body slows down This is why low-calorie diets can make you tired—your body is trying to balance the fact that you’re giving it less fuel by burning less fuel Studies show that it is very possible for dieters’ bodies to slow down so much that they won’t lose weight—may even gain it—at 1,500 calories per day, which is clinically considered a semistarvation diet The most discouraging thing about this diet-induced metabolic slowdown is that it doesn’t just go away when you stop dieting It persists for months As a result, you actually gain weight eating fewer calories than you did before That’s right Strict low-calories diets can actually make you gain weight

A Tale of Two Fuels

Another difference between your body and a car is that your body

is a dual-fuel machine Your car can run on only one fuel, line But your body can run on two fuels: glucose (“blood sugar”) and fat Think about it You’ve heard that you need carbohydrates for energy You’ve also been told that this or that exercise will get you into your “fat-burning zone.” The truth is, your body is happy

gaso-to burn either fuel

Again, the old saying “You are what you eat” is misleading Your body can quickly turn carbs to fat and fat and protein to carbs You don’t need to eat fat to get fat, and you don’t need to load up on carbs to keep your blood sugar up

Here’s the part you didn’t know: your body has to get rid of

glucose before it starts burning fat All carbohydrates turn to

glu-cose If you give your body a serving of carbohydrates every few hours, your body doesn’t bother to shift over to burning fat If you have, say, cereal and juice for breakfast, a granola bar midmorn-

ing, a sandwich with a soda for lunch, pasta or a potato with ner, and some chips in front of the television in the evening, your body can go through the whole day burning glucose instead of fat

din-If you have any glucose left over, your body will quickly turn it to fat and stash it on your belly, butt, or thighs

So the question becomes “How can I get my body to burn fat instead of glucose?” The answer is simple and logical: stop giving your body all that glucose

The Problem with Quick Energy

Maybe you have heard that carbohydrates give you “quick energy.”

It sounds good But is it?

Gasoline is quick energy, so quick that if you checked your gas tank by match light you’d be lucky to survive the experience That’s why your car has fuel injectors—to turn quick energy into slow, con-stant energy, to feed just a tiny bit of that gasoline into the engine at

a time But your body doesn’t have fuel injectors It has no way to use carbohydrates gradually High-carbohydrate meals simply didn’t exist until mankind started farming grains and beans ten thousand years ago That sounds like a long time, but in biological terms it really isn’t We come from hunter-gatherer ancestors who lived on meat, vegetables, and fruit in season, and our bodies are still made for that sort of diet, rather than for a diet based on grains and beans Rapidly digestible, high-carbohydrate foods such as starch are a very recent addition to the human diet, and we simply don’t have the mechanism to use big doses of it gradually

When you eat a big dose of starch—say, a plate of spaghetti and a couple of slices of garlic bread—it all turns into glucose and fl oods into your bloodstream very quickly Your blood sugar shoots up, and for the moment you feel satisfi ed But high blood sugar is dangerous, and your body knows it So it goes into action

to get your blood sugar back down

It’s All About Insulin

How does your body get your blood sugar back down? It releases

insulin No doubt you’ve heard that insulin is that stuff that

dia-betics take But what is it? What does it do?

Insulin is a hormone with a very specifi c task: it signals your body to take sugar out of your bloodstream, where it can cause trouble, and put it into your cells instead It opens “doors” on the

surface of your cells called insulin receptors If you’re using your

muscles at that moment—walking, working out, whatever—your muscles will be able to burn some of that glucose But if you’re sitting at your desk, sitting in your car, sitting in front of the televi-sion, your muscle cells aren’t going to be interested So the insulin tells your body to convert the glucose into fat, opens the doors on your fat cells—and puts it in the tank for later

Simply put, insulin is the fat storage hormone So long as you

have high levels of insulin in your bloodstream, your body will not

only put fat into the tank; it will keep fat from going out of the

tank Insulin tells your body to store fuel, not tap into it

The opposite occurs when your insulin levels fall Your body gets the message that it doesn’t have much glucose to run on and shifts over to burning fat for fuel instead That’s when your body

starts to draw fuel out of the tank.

Think back for a moment to our hunter-gatherer ancestors, the ones who didn’t eat grains and beans and therefore got only what little carbohydrate they found in wild vegetables and fruits,

at least on a day-to-day basis Most of the time, their bodies were running on fat from the game they ate (Yes, much game is lean, but even in wild animals the organ meats, marrow, brain, and other internal tissues are rich in fat, and hunter-gatherers actually preferred these parts to the muscle meat.) When game was scarce, prehistoric humans could forestall starvation by eating vegetation Although this was often largely indigestible carbohydrate such as grass, bark, roots, and unripe fruit, sometimes they found richer sources such as ripe fruit or even honey Let’s say they did get one big dose of carbohydrate—say they found a beehive and had

a big party, eating all that honey The honey would fl ood into their bloodstreams, their bodies would release insulin, and the glucose would be turned into fat and stored No big deal Because how often did they fi nd a beehive? Soon they’d be back to eating game, their insulin levels would drop, and they’d shift right back

to burning fat In the meantime, the honey they ate would become fat, which they could use for fuel for a week or two Simple and elegant

The whole thing got messed up when we started to eat big doses of carbohydrate all the time Indeed, modern humans con-sume hundreds of times more glucose in carbohydrates than their ancient ancestors did By causing our bodies to constantly release insulin, we keep ourselves in fat storage mode Our body takes all those calories and puts them into storage where we can’t get

at them, so we seem to be hungry all the time, even soon after we eat Our muscles, organs, and appetite centers in our brain stay

hungry, a state that has been called internal starvation We eat

plenty but never feel satisfi ed

And It Gets Worse: Insulin Resistance and

Type 2 Diabetes

For many of us, this constant oversue of our ability to turn glucose into fat for later turns really disastrous: our bodies stop respond-

ing to insulin, a condition called insulin resistance Those “doors”

on our cells, the insulin receptors, get harder and harder to open—think of them as having rusty hinges It takes more and more

and more insulin to open the doors and get the sugar out of our

blood Consequently, our insulin levels grow higher and higher, a

condition called hyperinsulinemia People with insulin resistance produce as much as six times the normal amounts of insulin, and

that’s the problem Excessive insulin, whether given as medication

or produced by the body, is notorious for causing weight gain Indeed, most overweight people have insulin resistance

These days, more people than ever have insulin resistance because we have become so sedentary A hundred years ago, peo-ple weren’t as susceptible as we are to obesity and diabetes because they were more physically active All it takes is about thirty min-utes of brisk walking to restore the body’s sensitivity to insulin, but many of us don’t even do that We ride to work in a car or bus, sit at a desk all day, then come home and watch television As we gain weight, exercise becomes more diffi cult, which contributes to insulin resistance as well The less we use our muscles, the rustier the hinges on the doors get As we slow down, our insulin resis-tance intensifi es However, the insulin receptors on our fat cells

continue to work just fi ne long after the others start to fail We can still store fat!

As insulin resistance progresses, our insulin levels rise as our bodies desperately try to open the doors on the cells and get the sugar out of our blood Eventually, the poor overworked insulin- producing cells in the pancreas virtually burn themselves out, insu-lin production decreases, and we end up with high blood sugar all

the time, which we call type 2 diabetes.

Stopping the Vicious Cycle

It’s simple to stop the vicious cycle Only two things are needed:

• Drastically lower your glycemic load

• Do thirty minutes of moderate aerobic exercise—walking

is just fi ne—four times a week

That’s it

Excessive amounts of insulin keep you hungry and encourage your body to store energy as fat Reducing glycemic load works to promote weight loss by preventing insulin from rising to unnat-urally high levels Research studies have repeatedly shown that people who reduce the glycemic load of their diet without even

trying to cut calories lose more weight than folks on low-fat diets

who try to cut calories.

If you just lower your glycemic load and oil the hinges of your muscle cells with moderate exercise, you reverse your insulin resis-tance and the insulin levels in your blood drop like a rock Your body stops socking away everything you eat into fat storage and starts acting like the dual-fuel machine it is, burning fat instead

of glucose for most of your needs Because you have enough fuel,

you stop feeling hungry every second of every day

As your energy levels increase, you’ll fi nd that exercise is not such an unpleasant idea Healthy bodies that have enough fuel like to move—just watch the kids at the playground if you doubt

it You can start easy Walking is as good an exercise as any for losing weight and increasing insulin sensitivity It takes only thirty

minutes to open those doors on your cells Or maybe you’d like to bike to the store, or putter around the garden, or even dance The

Russians have a wonderful phrase for it: muscular joy.

You’ll be able to actually enjoy using your body again

Glycemic Index Versus Glycemic Load

You hear the word glycemic all the time these days Magazines

recommend a “low glycemic diet,” often suggesting that such a diet should be high in fruits, vegetables, and whole grains (the fruit and vegetables are OK, but the “whole grain” is wrongheaded,

as we’ll get to in a moment.) Ads for prepackaged diet club meals claim that they’ve used the “secret of the glycemic index” so that

“carbs are no longer off limits.”

The problem is that magazine and television ads are unclear as

to the difference between glycemic index and glycemic load Trust

me There’s a big difference, and not understanding it can ruin your efforts to lose weight So let’s clarify the two terms

We’ll start with glycemic index, the older concept This is a

measure of how quickly any given carbohydrate food is absorbed into the bloodstream, which in turn governs how high blood sugar will rise as a result

How is glycemic index determined? A group of people has their fasting blood sugar tested and recorded They then eat a portion of the food to be tested That portion is calculated care-

fully to contain fi fty grams of carbohydrate available for

absorp-tion into the bloodstream—keep this point in mind, because we’ll

come back to it The subjects’ blood sugar is then tested at regular intervals to see how sharply it rises and falls These results, which can vary from person to person, are then averaged out

That average is then ranked against a “reference ally pure sugar or white bread The reference food is rated 100, and other foods are given a number indicating how they affect blood sugar in comparison to it For example, using white bread as reference food, oranges have a glycemic index of 60, which means

food”—usu-fi fty grams of available carbohydrate in an orange will raise blood sugar 60 percent as much as fi fty grams of available carbohydrate

in white bread will Even though the amount of glucose that

ulti-mately enters your body is the same, when it is consumed in the form of an orange it raises your blood sugar less than when it is delivered in the form of white bread.

Glycemic-index tests have turned up some surprising results For instance, in the 1970s a push started to get us to eat more

starches: bread, potatoes, cereal, pasta, rice, and the like It was

believed that starches were absorbed more slowly than sugar—

and that a starch-heavy diet would, therefore, lead to stable blood sugar levels and reduce hunger The glycemic-index measurements proved this to be wrong

For example, a baked potato has a glycemic index of 121, while sugar has a glycemic index of 115 This doesn’t mean that sugar is

a better food than potatoes, since the potatoes contain some mins and fi ber, while the sugar is nutritionally empty But it does mean that starches raise blood sugar just as much as pure sugar

vita-In fact, fi fty grams of carbohydrate from a baked potato actually

raises blood sugar a little more than fi fty grams of sugar will.

What Does Fifty Grams Have to Do with Reality?

Let’s go back to a point mentioned earlier Remember that the entists who measure the glycemic index always use a portion that contains fi fty grams of available carbohydrate The problem with this is that it bears no resemblance to the amounts of food people typically eat in real life It doesn’t take into account that some

sci-foods simply have a lot more carbohydrate per serving than others

do Take carrots They have a glycemic index of 68, high for a etable But do you realize how many carrots you’d have to eat to get fi fty grams of available carbohydrate? Carrots are full of indi-gestible fi ber, which is a carbohydrate, but it does not get absorbed into your bloodstream You would have to eat a pound and a half

veg-of carrots to get fi fty grams veg-of available carbohydrate Nobody eats that many carrots! You’d be hard-pressed to eat enough car-rots to move your blood sugar more than a point or two

On the other hand, whole wheat pasta has a glycemic index

of 53 That might sound better than carrots, but it takes only a cup and a half of pasta to get you to that fi fty-gram mark of avail-able carbohydrate—and most people eat more than a cup and a

half Very simply, people seldom consume enough vegetables to get excessive amounts of available carbohydrate but think nothing of consuming a couple hundred grams of carbohydrate in starches—pasta, rice, potatoes, bread, and the like A typical serving of these starchy foods contains a lot more available carbohydrate than a carrot or two does—and therefore will have a bigger effect on your blood sugar, despite the lower glycemic index.

This means that the glycemic index is not a clear guide to how foods will affect your blood sugar

Glycemic Load

Because the glycemic index doesn’t tell us how foods affect people

in real life, the concept of the glycemic load was developed Instead

of using the standard fi fty grams of available carbohydrate as a test food, the glycemic load takes into consideration the amounts

of food people typically eat Food scientists have discovered that you can estimate the glycemic load of a food by simply multiplying its glycemic index by the number of grams of available carbohy-drate in a typical serving: let’s use white bread and whole wheat bread as examples

White bread has a glycemic index of 100, and whole wheat bread has a glycemic index of 83, so you might think whole-grain bread would raise your blood sugar less than white bread, right? Wrong! A slice of white bread contains fourteen grams of available carbohydrate compared to twenty grams for a slice of whole-grain bread In other words, there’s just plain more food in whole wheat bread If you multiply the glycemic indexes by the grams of avail-able carbohydrate in a typical slice, you will fi nd that the glycemic load of a serving of whole-grain bread is 19 percent higher than that of a serving of white bread Using a slice of white bread as the reference food and giving it a glycemic load value of 100, the glycemic load of a slice of whole-grain bread is 119 Whole wheat bread not only raises your blood sugar 19 percent more than white bread does but contains more calories to boot Make no mistake, whole wheat bread will not help you lower your blood sugar or your insulin levels

Here’s another example of how the glycemic load differs from glycemic index, which illustrates another important point Let’s talk about candy Consider Life Savers They have a glycemic index

of 115, the same as pure sugar However, a single Life Saver weighs

just three grams Because it is so small, its glycemic load is only

20 Here is a case where a serving of candy, which you have been told to avoid since you were in diapers, is easier on your blood sugar than a slice of whole wheat bread, which you have been told

is good for you This holds true for some other candies, including chocolate A serving of two one-inch squares of chocolate has a glycemic load of 68, considerably less than a slice of bread

Look at it this way: a pile of candy the size of a typical ing of potatoes would raise your blood sugar as much as a pile

serv-of potatoes would The difference is, you usually don’t need a pile of candy that big to satisfy your sweet tooth The problem with candy is that some people have a hard time stopping, or they simply eat huge portions—candy bars have grown in size expo-nentially since my childhood! If you are a person who craves and binges on sweets, you are probably better off avoiding them alto-gether However, as long as the serving size is small—about as much as you can wrap your fi st around—it won’t raise your blood sugar as much as a slice of bread

The point is that the amount of available carbohydrate in a serving of food is at least as important as its glycemic index—if not more so.

So now you are prepared to understand the most important point of this book: although the glycemic indexes (not glycemic loads) of starches such as bread, potatoes, and rice are somewhat

higher than for other foods, the glycemic loads are several times

higher As you can see from the table in this section, whether

one fruit or vegetable has a higher glycemic load than another

is largely irrelevant None comes close to the blood-sugar lop starch delivers What the glycemic-load measurements tell you that’s going to change your way of eating is that the starches aren’t just a little worse than other foods They’re terrible!

wal-But here’s the good news When you look closely at a list of glycemic loads of the most common foods we eat, you can see

Table 1.1 Glycemic Loads of Common Foods

Typical Glycemic Food Item Description Serving Load

White bread 2 slices, 3 ⁄ 8 in thick 2¾ oz 260

Whole wheat bread 2 slices, 3 ⁄ 8 in thick 2¾ oz 234

French fries medium serving, McDonald’s 5¼ oz 219

Hamburger bun 5-in diameter 2½ oz 213

Corn on the cob 1 ear 5 1 ⁄ 3 oz 171

Blueberry muffi n 2½-in diameter 2 oz 169

Instant oatmeal (cooked) 1 cup 8 oz 154

Chocolate cake 1 slice (4 ⬙ ⫻ 4⬙ ⫻ 1⬙) 3 oz 154

Cookie (lab standard, 30 g) 1 medium 1 oz 114

Grapefruit juice, unsweetened 8-oz glass 8 oz 100

Pineapple 1 slice (¾ ⬙ ⫻ 3½⬙) 3 oz 50

that only four foods populate the top of the list: grain products,

potatoes, rice, and soft drinks (including fruit juices) Simplifying

further, the culprits are starchy solids and sugary liquids These

substances have two things in common: they both cause your

blood sugar to shoot up; and Americans have been consuming

increasing amounts of both as the obesity and diabetes rates have

skyrocketed If you do nothing else but eliminate these foods, the

glycemic load of your diet and the amount of insulin your body

has to make will be a fraction of what it was

This table assigns one slice of white bread a glycemic load

rating of 100 so that the glycemic loads of the other foods can be

viewed in terms of percentages of that of a slice of white bread

You will fi nd that some authors assign a slice of white bread a

rating of 10 To convert one system to another, simply multiply or

divide by 10 The glycemic loads of some of the foods in this table

vary from those of international listings to better approximate

American serving sizes

Typical Glycemic Food Item Description Serving Load

Table sugar 1 round teaspoon 1 ⁄ 6 oz 28

Carrot (raw) 1 medium, 7½ in long 3 oz 11

Cheese 1 slice (1 ⬙ ⫻ 1⬙ ⫻ 3⬙) 2 oz 0

Just Two Simple Rules: Avoid Starches and Sugared Beverages

This diet has just two rules:

By slashing your glycemic load, you’ll quickly fi nd you can trust your appetite If you simply eat to satisfy your hunger, stop when you’re full, and eat again when your hunger returns, calories will take care of themselves By lowering your insulin levels you’ll very likely fi nd that your blood pressure, cholesterol balance, and triglycerides improve rapidly—studies show that a low-glycemic-load diet improves heart disease risk factors more effectively than fat and cholesterol restriction did

As for trans fats, the vast majority of trans fats in your diet are coming from starchy foods, everything from crackers to micro-wave popcorn to commercially deep-fried foods By cutting out the starches, you’ll knock out most of the trans fats too

Starches Versus Everything Else

To lower your glycemic load, you need to avoid foods that have a lot of carbohydrate in a serving and release it into the bloodstream fast So which foods pack the biggest dose of carbohydrates into a serving and deliver it into the bloodstream the fastest? The answer

is starches If you can’t forgo starches altogether, a good rule of

thumb is never to eat more than a quarter serving of fl our ucts, potatoes, or rice at any time

prod-What are starches? Most of the American diet Take a look:

Pasta, noodles, macaroni, spaghetti

Potatoes and sweet potatoes

Cereal

Cornmeal

Grits

Anything made with fl our—even whole-grain fl our

This is not an exhaustive list, but you get the picture

I can feel you panicking now “That’s everything I eat!” I know That’s the problem

What Is Starch?

Starch is a white powdery substance found in large concentrations

in the seeds of plants Each starch molecule consists of hundreds

of sugar molecules linked by bonds that can be broken quickly by plant or animal digestive enzymes The seeds of certain grasses indigenous to regions with hot, dry summers are especially rich

in starch These include wheat, barley, rice, and corn The high concentrations of starch in these seeds provide a readily available source of sugar to jump-start seeds into sprouts during short grow-ing seasons No other food with the exception of pure sugar packs

as many carbohydrates into as small a space as starch does.What is it about starch that makes people gain weight? As soon as it hits your stomach, your digestive juices break it down to glucose Starch delivers more glucose molecules into your blood-

stream, and does it faster, than any other kind of food, with the exception of pure, refi ned sugar Your body’s insulin-producing cells have to make huge amounts of insulin to handle it, and that’s the problem Whereas small amounts of insulin actually curb appetite, excessive amounts, whether produced by your body or taken as medication, are notorious for causing weight gain.

Take a deep breath You’re going to be able to eat plenty of wonderful, fl avorful, satisfying food In fact, the food you’re going

to be enjoying will have far more fl avor than the starches you’re used to Why? Because starch itself has no fl avor None at all

Sugar You Can Taste Versus Sugar You Can’t Mother Nature

gave us taste buds to enjoy the food we eat, including reasonable

amounts of sugar, but we have no taste buds for starch Except

for about 2 percent of it that breaks down to sugar in our mouths, starch is tasteless Only when it arrives in your intestinal tract does

it turn to sugar Even though starch supplies most of the calories

in fl our products, potatoes, and rice, whatever fl avor these foods have comes from other ingredients

What’s the harm in not tasting the sugar that goes into your

bloodstream? Sugar you don’t taste is more likely to make you fat

than sugar you do taste Researchers found that sugar infused into

tubes inserted into people’s stomachs suppressed appetite less than sugar taken orally If you are going to consume sugar, you’re better off tasting it than letting it sneak into your stomach undetected by your taste buds

Doubt that starch has no fl avor? Try this: Put a pinch of starch or white fl our on your tongue How much fl avor does it have? How appealing is plain macaroni, boiled with no salt? That’s starch It’s the stuff you put on it that makes it taste good—and you can have the stuff that tastes good

corn-Liquid Candy

The quantity of sugar-water Americans swill down has increased frighteningly over the past few decades Somewhere along the line the standard serving went from a twelve-ounce can to a twenty-

ounce bottle, a 66 percent increase Fountain drinks are nearly big enough to swim in Forty-two-ounce servings—far more than

a quart—are not uncommon Many people never drink anything that isn’t sweetened The black coffee of an earlier generation has turned into the mochaccino of the modern coffee kiosk We even have a whole new class of alcoholic beverages, the sugary “alco-pops”—coolers, hard lemonades, and the like—to appeal to young adults who can’t imagine drinking anything that isn’t sweet

So it is not surprising that far and away the single biggest source

of sugar in the American diet is beverages How much sugar do we get from them? That twenty-ounce bottle of cola contains fourteen teaspoons of sugar That’s more than a quarter of a cup

Is juice better? No Remember, you’re taking the sugar out

of fi ve or six pieces of fruit and putting it in a glass Fruit—in its natural form—is healthy You have to bite it, chew it, and swallow it, all of which slows you down The sweetness has time

to register in your brain The high fi ber content fi lls you up and slows the absorption of the sugar into your bloodstream The vitamins and minerals in it prevent food cravings Remove the

fi ber—which is what juicing does—and concentrate the sugar from several pieces of fruit into one serving, and suddenly you can consume more sugar, more quickly, without feeling satisfi ed How much sugar? Apple juice contains more sugar, ounce for ounce, than soda does (Twenty ounces of apple juice contain a third of a cup of sugar!)

“But it’s natural sugar!” I hear you cry Your body doesn’t

care Sugar is sugar is sugar It still will raise your blood sugar.

Worse, it appears the body doesn’t register sugar when we drink it rather than eat it Scientists have discovered that unlike the sugar in solids such as candy, the sugar in liquids does not reduce the amount of other foods we eat We just add that sugar

to what we would have eaten anyway

The only other group of foods that have glycemic loads as high as those of starches are sugar-containing soft drinks Just one

sugar-sweetened beverage a day will double your risk of diabetes

and obesity This includes fruit juices—orange and apple juice—as well as sodas

Hence your second rule: no sugary beverages This means no:

Sugar-sweetened soda

Gatorade and other sports drinks

Sweet tea, raspberry iced tea, and other sweet versions of fountain iced tea

Bottled sweetened iced tea, unless the label says sugar-free Lemonade, unless the label says sugar-free

“Fitness waters” unless the label says sugar-free

“Vitamin waters” unless the label says sugar-free

Milk shakes

Chai

Chocolate milk and other sweetened milks

Red Bull and other “energy drinks”

Sweet coffee drinks, both bottled and from the coffee standFruit juice, juice drinks, juice blends, iced tea with juice

In short, if a beverage tastes sweet, but is not artifi cially ened, it’s out If it leaves your glass sticky, it’s out

sweet-Is Natural Sugar Healthier than Artifi cial Sweeteners?

I’d like to tackle a question I hear a lot: “Aren’t artifi cial ers dangerous? At least sugar is natural!”

sweeten-Yes, sugar is natural (although the high-fructose corn syrup that sweetens most beverages is very defi nitely a man-made prod-uct) So what? Tobacco is natural Cocaine is natural Poisonous mushrooms are natural “Natural” does not mean “safe.”

There is nothing natural about consuming the vast quantities

of sugar that Americans get in beverages There is no precedent for it that we know of in all of human history Our bodies are not

made to deal with it, and it is killing us.

I don’t know if artifi cial sweeteners are 100 percent safe, but then I don’t know of anything that is 100 percent safe I am, how-ever, convinced that they are safer than what they replace It is best that you learn to drink far fewer sweet beverages, even diet soda—there’s no evidence that diet soda has made a dent in obesity rates

But if artifi cial sweeteners are what it takes to get you to stop mainlining sugar, I think they’re worth it, especially as a stepping-stone to learning that a liquid need not be sweet.

So What Can I Eat and Drink?

The simple answer is any solid that’s not starchy and any liquid

that isn’t sweetened with sugar That will include:

Meat, including beef, pork, lamb

Poultry, including chicken, turkey, duck, Cornish game henFish and seafood

Coffee, hot or iced

Tea—regular and herbal, hot or iced

Artifi cially sweetened beverages, if you must

Sparkling water and club soda

Milk

Light beer

Wine

Spirits

And of course, good old water

In the following chapters, Dana will give you a ton of ideas for turning these foods into a rich, delicious, varied, and satisfy-ing cuisine!

2

Going Low Glycemic Load

Before we get to the recipes, here is a variety of

infor-mation that will make shifting over to a load lifestyle easier for you

low-glycemic-Convenience Foods

Chances are you’re not a “foodie.” Up until you realized your health depended on changing your eating habits, you’ve probably depended on the same packaged, processed convenience foods that everyone else eats You know, don’t you, that you can’t rely on all this starchy garbage anymore?

“But,” you protest, “I have a job! I have kids! I have a million things to do! I don’t always have time to cook!” Or maybe you simply hate to cook and have picked up this book out of despera-tion over your health issues

Good news: there are convenience foods that fi t the load diet Your menu will be more interesting if you cook, but you

glycemic-don’t have to.

These convenience foods may put a ding in your budget Unlike the convenience foods you’re used to, these aren’t based on cheap

starch But you know what? Food that makes you fat, sick, tired, and hungry wouldn’t be cheap if they were giving it away.

Here are some great convenience foods that work for the glycemic-load diet:

In the Deli

• Rotisserie chicken The ultimate low-glycemic-load

convenience food A rotisseried chicken plus bagged salad makes a quick and satisfying supper

• Deli meats Great for low-carb tortilla wraps, of course,

but also try unsandwiches—spread your condiments between a couple of slices of cold cuts and roll them up inside a lettuce leaf, along with a slice of tomato if you like

• Deli salads and vegetables Skip the potato and macaroni

salads Look for coleslaw, roasted vegetables, sautéed green beans in olive oil, and other interesting vegetable dishes And don’t forget chicken salad and tuna salad

In the Freezer Case

• Frozen hot wings Nuke and eat Watch out for breading.

• Frozen hamburger patties Read the label to avoid starchy

fi llers

• Frozen grilled fi sh fi llets These come with garlic butter,

Cajun seasoning, lemon pepper, Italian herbs, and other seasonings

• Frozen vegetables I know fresh vegetables are the choice

of gourmets everywhere, but I’m in favor of anything that gets you and your family to eat your darned vegetables Just microwave, butter, and eat Great for soups and stews too And with a bag of stir-fry blend and some boneless, skinless chicken in the freezer, plus a bottle of your favorite stir-fry sauce on the shelf, you’re never more than ten minutes away from a great meal Be careful, though More and more frozen vegetable blends include noodles and other starchy ingredients Be clear on what you’re getting

• Frozen fruit Frozen fruit of every kind is great to keep

on hand for smoothies or for tossing into yogurt In the winter, the frozen ones are often better than the fresh ones anyway Use frozen unsweetened peach slices in any recipe that calls for cooking the peaches It’s a lot easier than peeling and slicing all those peaches!

In the Meat and Fish Department

• Preskewered kabobs Just throw them on the grill or under

the broiler

• Precooked ham and turkey ham The kind in a big oval

chunk Brown a slice or two in butter to eat with eggs or cut cubes to scramble into them Brown a slice of ham per customer in butter, fl ip, and while the other side is browning, spread the top with mustard and cover with Swiss or cheddar cheese Or just cut off a slice and stuff it

in your face

• Cooked chicken breast strips Great for tossing in a salad,

fi lling an omelet, or making a wrap sandwich in a carb tortilla

low-• Precooked shrimp Toss into a salad or dip in cocktail

sauce

• Precooked crab legs Dip in cocktail sauce or go for the

lemon butter

• Precooked bacon I haven’t tried this, but I know people

who swear by it The best part, they say, is that you don’t have all that grease to deal with

In the Canned-Meat Aisle

• Canned or pouch-pack tuna Tuna salad takes fi ve minutes

to throw together Bagged salad tossed with bottled

dressing and topped with tuna is even quicker Tuna now comes in various fl avors, by the way, but read the labels and watch out for starchy additives

• Canned crab, chicken, chunk ham, salmon See tuna.

• Smoked salmon Put it in an omelet or serve it on a salad.